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Knee Mechanics and Pathomechanics (1st Year)
Knee Mechanics and Pathomechanics (1st Year)
University of Rwanda
College of Medicine and Health Sciences
School of Health Sciences
Physiotherapy Department, 1st Year
Huye Campus 2023
NDAHIRIWE CC
⦿ Participating bones –
⚫ Femur
⚫ Tibia
⚫ Patella
⦿ Ginglymus – (Hinge) ?
⚫ A freely moving joint in which the bones are so
articulated as to allow extensive movement in
one plane.
⦿ Arthodial – (Gliding) ?
⦿ 6 degrees of freedom
⚫ 3 Rotations
⚫ 3 Translations
⦿ Collateral ligament
⚫ Medial collateral ligament (MCL)
⚫ Lateral collateral ligament (LCL)
⦿ Cruciate ligament
⚫ Anterior cruciate ligament (ACL)
⚫ Posterior cruciate ligament (PCL)
⦿ Posterior capsular ligament
⦿ Meniscofemoral ligament
⦿ Iliotibial band
NDAHIRIWE CC University of Rwanda CMHS PT Dpt 25
NDAHIRIWE CC University of Rwanda CMHS PT Dpt 26
MCL
• ⦿ Attachment –
⚫ Origin – medial aspect of medial femoral condyle
⚫ Insertion – proximal tibia
• ⦿ Function –
⚫ Resist valgus stress force (specially in MCL
• extended knee)
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⦿ Oblique popliteal ligament
35
OBLIQUE POPLITEAL LIGAMENT
⦿ Attachment –
⚫ Origin – The central part of posterior aspect of
NDAHIRIWE CC
the joint capsule
⦿ Attachment –
⚫ Origin – Near the proximal origin of the MCL
and adductor tubercle
⚫ Insertion – Posteromedial tibia, posterior capsule
& posteromedial aspect of the medial meniscus
⦿ Function –
⚫ Reinforces the posteromedial knee joint capsule
obliquely on a medial-to-lateral diagonal from
proximal to distal
NDAHIRIWE CC University of Rwanda CMHS PT Dpt 37
Arcuate Ligament
Lateral Branch Medial branch
Distal
From posterior aspect of the head of the fibula
Attachment
Proximal To tendon of popliteus Into oblique popliteal lig on
Attachment muscle & posterior capsule medial side of joint
Reinforces the postero-lateral knee joint capsule
Function
obliquely on a medial to lateral from proximal to distal
⦿ Pre-patellar bursa –
⚫ Located between the skin & anterior surface of patella
⚫ They allows free movement of skin over patella during
knee flexion & extension
⦿ Subcutaneous bursa –
⚫ Located between patellar ligament & overlying skin
⦿ Deep infra-patellar bursa –
⚫ Located between patellar ligament & tibial tuberosity
⚫ Helps in reducing friction between the patellar
ligament & tibial tuberosity
NDAHIRIWE CC University of Rwanda CMHS PT Dpt 40
NDAHIRIWE CC University of Rwanda CMHS PT Dpt 41
TF CKC FLEXION
⦿ Early 00 - 250 knee flexion –
⚫ Posterior rolling of femoral
condyles on the tibia
⦿ As flexion continues –
⚫ Posterior Rolling accompanied by
simultaneous Anterior glide of femur
⚫ Create a pure Spin of femur on the
posterior tibia
Menisco-patellar
Ligaments
NDAHIRIWE CC University of Rwanda CMHS PT Dpt 53
TF OKC FLEXION ARTHROKINEMATICS
SAGITTAL PLAN
⦿ Flexion – Menisci migrate posteriorly because of
⚫Semimembranosis attachment to medial meniscus
⚫Popliteus attachment to lateral meniscus